Project Grant Research Articles

Prognostic evaluation of ST-segment elevation acute myocardial infarction according to lung ultrasound in the acute phase

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): JC-M received an Original Research Projects Grant from the Catalan Society of Cardiology and LR-S received Scholarship for Training and Research from the Association of Ischemic Heart Disease and Cardiological Critical Care of the Spanish Society of Cardiology. Introduction Lung ultrasound (LUS) has emerged as a useful diagnostic and prognostic tool in heart failure (HF) and has shown promise in risk stratification for ST-segment elevation myocardial infarction (STEMI) in the acute phase. These studies consistently indicate that the degree of pulmonary congestion, assessed by the number of B-lines on LUS, is significantly associated with a worse prgnosis during hospitalization and short-term follow-up in STEMI patients. However, this prognostic value has mainly been evaluated during hospital admission or a few days after discharge without a long-term follow-up. Purpose To assess the prognostic value of LUS at one year in patients admitted for STEMI. Methods In a prospective multicenter cohort study involving STEMI patients, an independent operator performed LUS during the first 24 hours after revascularization and offline B-line counting was conducted. LUS results were assessed both as a categorical [wet (at least one site with ³3 B-lines)/dry lung] and continuous variable (total number of B-lines). The primary endpoint was a composite of death or hospitalization for HF, acute coronary syndrome, or stroke within one year. Results A total of 173 patients were included. The composite endpoint occurred in 13.7% of the patients over a median follow-up of 368 days. LUS was able to predict the composite outcome with hazard ratios (HR) of adjusted hazard ratios of 4.85 (95% CI 2.79-8.43) for having a wet lung and 1.13 (95% CI 1.09-1.18) for each B-line. After and adjustment for sex, age, chronic kidney disease, previous atrial fibrillation, Killip class and left ventricular ejection fraction HR was 1.72 (95% CI 0.91-3.28) for having a wet lung and 1.06 (95% CI 1.00-1.11) for each B-line. Conclusion Detecting B-lines on LUS predicts adverse events at one year in STEMI patients.Kaplan-Meier curves

The National MD-PhD Program Outcomes Study: career paths followed by Black and Hispanic graduates.

Previous studies on attrition from MD-PhD programs have shown that students who self-identify as Black are more likely to withdraw before graduating than Hispanic students and students not from groups underrepresented in medicine (non-UIM). Here, we analyzed data collected for the National MD-PhD Program Outcomes Study, a national effort to track the careers of over 10,000 individuals who have graduated from MD-PhD programs over the past 60 years. On average, Black trainees took slightly longer to graduate, were less likely to choose careers in academia, and were more likely to enter nonacademic clinical practice; although, none of these differences were large. Black graduates were also more likely to choose careers in surgery or internal medicine, or entirely forego residency, and less likely to choose pediatrics, pathology, or neurology. Among those in academia, average research effort rates self-reported by Black, Hispanic, and non-UIM alumni were indistinguishable, as were rates of obtaining research grants and mentored training awards. However, the proportion of Black and Hispanic alumni who reported having NIH research grants was lower than that of non-UIM alumni, and the NIH career development to research project grant (K-to-R) conversion rate was lower for Black alumni. We propose that the reasons for these differences reflect experiences before, during, and after training and, therefore, conclude with action items that address each of these stages.

Digital stewardship for river stewardship: creating the Richmond River open access repository

ABSTRACT The catchment of the Richmond River in Lismore, Australia, presents a challenge for record collection and preservation. Firstly, material records belonging to the community are periodically destroyed in flooding. The places where these are physically located as historical archives are often situated in the floodplain. Secondly, relevant records are dispersed across multiple government levels and organizations, posing further threats to their preservation and access. This paper seeks to explore those challenges and describe the development of a river repository at Southern Cross University, funded in part through a grant for flood recovery projects. The repository and our research are motivated by the challenges and considerations surrounding the preservation and management of cultural and scientific materials in the current era, characterized by human impact on the environment and climate change and the integration the Anthropocene heralds between the human and non-human world. Digital stewardship encompasses caring for and managing records and data, goals we extend to the Richmond River and its health.

Cerebrovascular Conductance Responses to Carbon Dioxide are Attenuated by the Presence of Hypertension in Patients with Atrial Fibrillation

The cerebral vasculature is highly sensitive to carbon dioxide (CO2) and cerebrovascular CO2 reactivity (CVRCO2) is widely used to index cerebral vascular health. Some studies have shown that both atrial fibrillation (AF) and hypertension (HTN) are independently associated with reduced CVRCO2. However, it is unknown if these effects on CVRCO2 are synergistic when AF and HTN are present together. In this study we tested the hypothesis that CVRCO2 was lower in patients with both AF and HTN (AF+HTN) compared to normotensive patients with AF. Transcranial Doppler ultrasound was used to measure middle cerebral artery blood velocity (MCA Vm) in AF (n=31) and AF+HTN (n=57) during stepped increases and decreases in end-tidal carbon dioxide (PETCO2). The ratio of MCA Vm and mean arterial pressure (MAP) was defined as cerebrovascular conductance index (CVCi). CVRCO2 was taken as the linear slope for MCA Vm and MCA CVCi versus PETCO2. As expected, baseline MAP was higher in AF+HTN than AF (107±9 vs. 98±9 mmHg, respectively; p<0.001). Baseline MCA Vm was numerically lower in AF+HTN than AF, but this did not reach statistical significance (50 [44-60] vs. 52 [45-63] cm.s−1, respectively; p=0.075), while baseline CVCi was lower in AF+HTN compared to AF (0.46 [0.42-0.57] vs. 0.54 [0.44-0.63] cm.s−1.mmHg−1; p<0.001). MCA Vm CVRCO2 was not different between groups (1.70 [1.47-2.19] and 1.74 [1.54-2.52] cm/s/mmHg−2 for AF+HTN and AF, respectively; p=0.221), whereas MCA CVCi CVRCO2 was 13% lower in AF+HTN compared to AF (0.013 ± 0.004 vs. 0.015 ± 0.005 cm.s.mmHg−2; p=0.047). Stepwise linear regression analysis identified that cardiac rhythm during data acquisition (AF or normal sinus rhythm) was a predictor of baseline MCA CVCi and MCA CVCi CVRCO2. In summary, our results demonstrate impaired MCA CVCi CVRCO2 in AF+HTN and suggest that the presence of HTN worsens cerebrovascular function in AF. Such cerebrovascular alterations may be important for the development of cognitive decline and diminished brain health in AF. Funding provided by Bristol-Myers Squibb/Pfizer Alliance Project Grant (CV185-481), British Heart Foundation Project Grant (PG/15/45/31579) and the National Institute of Health Research Clinical Research Network (NIHR CRN). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Cerebrovascular Dysfunction in a Mouse Model of Marfan Syndrome: Increased Vulnerability to Neuropathology & Mild Traumatic Brain Injury

Marfan syndrome (MFS) is a connective tissue disorder (CTD) associated with mutations in fibrillin-1 ( Fbn1), leading to chronic systemic increases in transforming growth factor-β (TGF-β) availability and signaling that could lead to aortic wall weakening and aneurysm/rupture. TGF-β has been implicated in cerebrovascular dysfunction, loss of blood-brain barrier (BBB) integrity, age-related neuroinflammation and neurological deficits. Improvements in MFS treatment and life expectancy have uncovered a risk for systemic vascular dysfunction including cerebrovascular complications such as stroke, and cerebral aneurysm. Therefore, we hypothesized that Fbn1 mutation ( Fbn1C1041G/+) is associated with systemic vascular dysfunction, BBB permeability, neuroinflammation, neurobehavioral alterations, and impaired glutamate homeostasis, leaving the brain more vulnerable to mild traumatic brain injury (mTBI). Our experimental groups included: 6M-old male and female MFS ( Fbn1C1041G/+) and C57BL/6 (WT) control, and middle-aged 12M WT mice (N=3-10/group, P < 0.05). In vivo ultrasound imaging analyzed by two blinded investigators demonstrated increased aortic root diameters and stiffness in MFS mice compared to 6M and 12M WT mice, where MFS male diameters were affected more than females. Vascular dysfunction measured by blood flow velocity (BFV) extended to the left pulmonary artery where 6M MFS and 12M WT mice were reduced compared to 6M WT mice. This reduction continued through decreased posterior cerebral artery BFV in MFS males, where MFS females were comparable to 6 and 12M WT females. In 6M MFS male mice, Evans blue extravasation and Immunoglobulin G staining demonstrated increased BBB permeability in the hippocampus to large and small molecules, respectively, as well as to small molecules in the lateral hypothalamus as compared to 6M WT and like 12M WT. In adjacent sections, iba-1-stained cells had morphologies indicative of reactive microglia. In vivo electrochemical recordings in the hippocampus showed a trend towards lowered peak glutamate amplitudes and elevated baseline glutamate concentrations in MFS and 12M WT mice demonstrating disrupted glutamate homeostasis. Furthermore, exogenous TGF-β applied in the lateral hippocampus of 6M WT males revealed an evoked glutamate response that may support this elevated baseline in MFS mice. Higher neurobehavioral severity scale (NSS) scores in 6M MFS mice suggested neurobehavioral alterations that were more like 12M WT. Midline fluid percussion was used to induce mTBI, where 6M MFS male mice and both female groups required a 15% lower pressure to induce mTBI righting reflex times (5-10 minutes) compared to 6M WT male mice. Mice were evaluated at 1-day post injury, where BBB permeability to large and small molecules and microglia activation were increased, glutamate clearance was slowed, and NSS scores were increased compared to 6M WT and were like 6M MFS and 12M WT mice. These novel findings signify MFS as a condition of systemic vascular dysfunction and pre-mature cerebrovascular aging phenotype with more vulnerability to brain injury. Funding: NIH-R36AG083385, Valley Research Partnership-P1A-5012, NIH-R15HL145646, NIH-R01NS100793, Midwestern Graduate Funds, Phoenix Children’s Hospital Leadership Circle, Graduate and Professional Council Research and Projects Grant. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Pathway analysis for functional characterization of microRNAs

DIANA-miRPath webserver enables the exploration of combined miRNA effects using predicted or experimentally supported miRNA interactions. Its latest version (DIANA-miRPath v4.0, http://www.microrna.gr/miRPathv4 ), introduces the capacity to tailor its target-based miRNA functional analysis engine towards specific biological/experimental contexts. Via a modular interface with rich interaction, annotation and parameterization options, users can perform enrichment analysis on Gene Ontology (GO) terms, KEGG and REACTOME pathways, gene sets from Molecular Signatures Database (MSigDB) and PFAM. Included miRNA interaction sets are derived from state-of-the-art resources of experimentally supported (DIANA-TarBase v8.0, miRTarBase and microCLIP cell-type-specific interactions) or from in silico miRNA-target interactions (DIANA-microT-2023 and TargetScan predictions). Bulk and single-cell expression datasets from The Cancer Genome Atlas (TCGA), the Genotype-Tissue Expression project (GTEx), as well as single-cell expression atlases can be used to assess expression change of targeted genes within terms, across a wide range of states. A discrete module to perform miRNA-tailored CRISPR knock-out screen analyses deems possible the investigation of selected miRNAs within conditions under study. Hellenic Foundation for Research and Innovation (HFRI) under the 1 st Call for HFRI Research Projects to Support Faculty Members & Researchers and Procure High-Value Research Equipment grant (Project Number 2563). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Endothelin-1 Correlates with Blood Pressure and Pulse Pressure in Females with Lupus Associated Hypertension

Systemic Lupus Erythematosus (SLE) is a common autoimmune disease that is classified by IgG complex deposition in end organs including the kidney, heart, and vasculature. SLE disproportionally affects women to men (9:1 ratio), with a high prevalence in African American women. Importantly, patients with an SLE diagnosis have common cardiovascular complications including hypertension. Importantly, numerous studies have reported that plasma and urinary endothelin-1 (ET-1) levels are elevated in patients with SLE or hypertension. However, few studies have investigated the role of the synergistic effects of SLE and hypertension on ET-1. Therefore, we hypothesized that women with SLE and hypertension would have elevated plasma ET-1 levels compared to SLE or hypertension alone. To investigate this, we recruited non-SLE non-HTN controls (n=8), non-SLE HTN (n=7), SLE non-HTN (n=5), and SLE-HTN (n=6) female human subjects and analyzed clinical and demographic characteristics, plasma ET-1, c-reactive protein (CRP), soluble vascular adhesion molecule-1 (sVCAM-1), and anti-Smith autoantibodies. We found that plasma ET-1 levels are significantly higher in African American compared to European American patients independent of SLE or blood pressure status (p=0.0182). When plasma ET-1 levels were correlated with age and body mass index (BMI), ET-1 had a positive association with age (r=0.4861;p=0.0118), but no correlation with BMI (r=0.2137;p=0.2945). When subjects we characterized by SLE diagnosis, we found that female subjects with SLE had elevated plasma ET-1 levels compared to non-SLE controls (p=0.0141). Next, we stratified subjects by blood pressure status and found that only SLE-HTN subjects had significantly elevated plasma ET-1 levels compared to non-SLE non-HTN controls (p=0.0005), and a trend for elevated ET-1 levels over SLE non-HTN (p=0.0799). Lastly, we correlated plasma ET-1 levels to offce systolic blood pressure, diastolic blood pressure and calculated pulse pressure. We found that plasma ET-1 positively associated with systolic blood pressure (r=0.5621;p=0.0035) and pulse pressure (r=0.5810;p=0.0023) but not diastolic blood pressure (r=0.3177;p=0.1217). These data demonstrate that plasma ET-1 levels associate with SLE diagnosis and blood pressure status in our cohort of female SLE human subjects. Further investigation of ET signaling should be done in SLE and SLE-HTN human subjects. Veterans Affairs Biomedical Laboratory Research & Development Career Development Award (CDA-2) 1IK2BX005605-01 to J.P.V.B, Medical University of South Carolina College of Medicine Program Project Grant to J.C.O and J.P.V.B., and Medical University of South Carolina Core Centers for Clinical Research Project Award P30AR072582 to M.A.C and J.P.V.B. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sex Differences of the Endothelin System in the Cardio-Renal Axis of a Lupus Prone Mouse Model

Systemic Lupus Erythematosus (SLE) is the most common form of lupus autoimmunity. It is characterized by overactivation of toll-like receptor 7 (TLR7) and immune complex deposition in target organs including the kidney and vasculature. A lupus diagnosis disproportionately affects women at a rate of 9:1 compared to men. Clinically, patients present with heterogenous symptoms including chronic hypertension, heart failure, renal failure, vascular disease, and neuropathies. Despite a variety of clinical presentations of lupus, elevated endothelin-1 (ET-1) has been detected in both male and female lupus patients' plasma compared to healthy controls. However, the exact sex differences in ET-1 in the development of lupus and its associated cardiovascular complications remain unknown. Therefore, we hypothesized that acceleration of SLE through TLR7 activation promotes sex-dependent regulation of the ET system within the cardiorenal axis. To investigate this, female and male lupus-prone B6.Nba2 mice were treated with a TLR7/8 agonist (R848; 100ug/30ul) or acetone as a control topically twice a week for 4 weeks. After the R848 treatment, mice were followed for 12 more weeks until the 16-week terminal timepoint where the kidney and heart tissues were collected and tissue ET-1, endothelin receptor A (ETA) and endothelin receptor B (ETB) were analyzed by ELISA, RTqPCR, and immunoblotting. At the RNA level, cardiac Ednra expression trended towards upregulation in females, whereas males remained unchanged compared to their respective controls. At the protein level, both sexes tended to decrease ETA receptor levels. Renal Ednra expression trended towards downregulation in females but was unchanged in treated males, which was opposite of renal protein ETA where females were unchanged, and males trended towards reduction. Interestingly, Ednrb and Edn1 trended towards an increase in both the cardiac and renal system in both sexes. However, at the protein level only female cardiac ET-1 was significantly elevated (p<0.0001) while renal ET-1 levels were unchanged. Males demonstrated a significant increase in both cardiac (p=0.0004) and renal ET-1 (p=0.0127). Analysis of female cardiac ETB receptor levels yielded a significant reduction (p=0.0025) and an increasing trend in renal levels. Both cardiac and renal ETB was unchanged in males. The sex differences in the cardiorenal ET system regulation warrants further exploration and possible therapeutic treatments into cardiorenal lupus associated pathologies. Veterans Affairs Biomedical Laboratory Research & Development Career Development Award (CDA-2) 1IK2BX005605-01 to J.P.V.B, Medical University of South Carolina College of Medicine Program Project Grant to and J.P.V.B., and Medical University of South Carolina Core Centers for Clinical Research Project Award P30AR072582 to M.A.C and J.P.V.B. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

High Fat Feeding Blunts Skeletal Muscle Oxygen Mediated Blood Flow Responses in Healthy and Type 2 Diabetic Rats

Hypothesis: High fat diet feeding impairs microvascular blood flow responses to dynamic changes in local oxygen concentration ([O2]) in Sprague-Dawley (SD) and Zucker Diabetic Sprague-Dawley (ZDSD) rats. Methods: Seven-week-old male SD and ZDSD rats were fed either a standard chow (N = 7 SD, 5 ZDSD) or a high saturated fat diet (N = 8 SD, 6 ZDSD) for 7 weeks. At 14 weeks of age animals were anaesthetized, instrumented for systemic monitoring, and mechanically ventilated. The extensor digitorum longus muscle was blunt dissected and reflected over a gas exchange chamber imbedded in the stage of an inverted microscope. Microvascular blood flow responses to high and low [O2] challenges (7 – 12 %, and 7 – 2 %) and sequential changes in [O2] (7 – 12 – 2 – 7 %) were recorded at baseline and during hyperinsulinemic-euglycemic clamp. Gas conditions within the chamber were set at 7 % for a 1-minute baseline followed by 2 minutes at either 2 or 12 % O2. The 4-minute square wave oscillation consisted of 1 minute at each [O2] (7 – 12 – 2 – 7 %). Hyperinsulinemic-euglycemic clamp was achieved by simultaneous infusion of insulin (2 U/hr/kg) and variable rate of 50 % glucose until euglycemia was reached (5 - 7 mM blood glucose). Analysis of intravital videos was completed using custom MATLAB software. All animal protocols were approved by Memorial University’s Animal Care Committee. Results: Chow fed SD had significantly higher glucose infusion rates compared to high fat fed SD, chow fed ZDSD, and high fat fed ZDSD (28.11 ± 1.807 vs. 25.14 ± 1.18, 24.56 ± 2.78, 24.77 ± 2.43 mg/kg/min, p = 0.0429, 0.0305, 0.0323, respectively). Red blood cell (RBC) saturation significantly increased and decreased in all groups within 4 s following the increase and decrease in [O2], respectively. Chow fed SD had significant decrease in RBC supply rate (SR) in response to 12 % [O2] (10.41 ± 11.31 vs 7.44 ± 8.40 cells/s, p < 0.0001, τ = 15.85 s). In response to low [O2], significant increases in SR were measured in the chow fed SD and ZDSD groups (7.10 ± 8.76 vs 11.65 ± 11.36 cells/s, p < 0.0001, τ = 17.65 s, and 10.86 ± 13.62 vs 13.86 ± 14.69 cells/s, p < 0.0001, τ = 85.74 s, respectively). High fat fed SD and ZDSD had significant increases in RBC SR during 2 % [O2] (8.47 ± 9.75 vs 11.84 ± 12.11 cells/s, p < 0.0001, τ = 68.49 s, and 16.09 ± 18.12 vs 20.73 ± 21.92 cells/s, p < 0.0001, τ = 23.98 s). High fat fed ZDSD had higher, but not significantly different, baseline RBC SR compared to the chow fed ZDSD group. Chow fed SD were the only group to have an increase in RBC SR at low [O2] during hyperinsulinemic-euglycemic clamp (13.80 ± 17.78 vs 18.07 ± 20.25 cells/s, p = 0.0003, τ = 10.88 s). Conclusions: High fat feeding impairs the capillary blood flow response to local increases in [O2] in healthy and high fat fed T2D model rats. Chow fed ZDSD rats had slower capillary blood flow dynamics than the SD control group. Hyperinsulinemic-euglycemic clamp diminishes the O2 mediated blood flow response in 14-week-old SD and ZDSD rats fed a high fat diet. This project was supported by the Canadian Institute of Health Research through a project grant to GMF. Studentships were supported by Memorial University's School of Graduate Studies and the Faculty of Medicine. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Sex Differences in Temporal Regulation of Piezo1 in Resiquimod Accelerated Systemic Lupus

Lupus disproportionally affects women (9:1), particularly women of color, but men with this disease often have more pronounced symptoms than their female counterparts. Individuals with lupus are anywhere from two to fifty times as likely to experience a cardiovascular (CV) event than the rest of the population. Though such complications are widely known, the mechanisms these disease processes are unknown. One well established pathogenesis of many CV diseases stems from an alteration of mechanical forces. The cation channel, Piezo1, is a mechanosensitive channel and is known to play a critical role in CV diseases like heart failure. Therefore, we hypothesized that inducing lupus-associated cardiac pathology in a lupus-prone mouse model would increase the expression of Piezo1. To investigate this, lupus-prone female and male B6.Nba2 mice aged 10-14 weeks were subjected to Resiquimod (R848; a TLR7/8 agonist;100μg/30μl) treatment or acetone vehicle twice a week for four weeks. Echocardiograms were performed every four weeks. Mice were sacrificed and their tissues harvested at 4- and 16-weeks after the start of R848 treatment. Piezo1 levels were subsequently analyzed in the heart by real time quantitative polymerase chain reaction (RTqPCR), immunoblot, and immunofluorescent staining. By echocardiography, female mice treated with R848 showed an increase in left ventricle (LV) wall thickness was seen at four weeks, followed by an increase in internal diameters over the following 12 weeks, culminating in cardiac dysfunction by 16 weeks via significantly decreased ejection fraction (EF; p<0.05) Interestingly, males showed no such cardiac dysfunction at any timepoint. By RTqPCR, female Piezo1 levels were higher overall than their male counterparts (p<0.05). Cardiac Piezo1 gene expression at 4 weeks was shown to be decreased in the R848-treated groups of both sexes. At 16 weeks, this trend was reversed in both male and female mice, showing R848-treatment induced an an upregulation of cardiac Piezo1 compared to each sex’s respective vehicle controls. Interestingly, while Piezo1 protein expression followed the same 4-week trend of downregulation in R848-treated mice regardless of sex, protein expression in the female R848-treated heart continued in a trending increase at the 16-week timepoint, while the male R848 heart showed unchanged. We found that this increase in cardiac Piezo1 in female, R848-treated is significantly correlated with higher left ventricular internal diameters (both LV-EDV (p<0.05) and -ESV (p<0.01)). This data demonstrates a sex difference phenotype in lupus-associated murine cardiac dysfunction, potentially through a Piezo1-mediated pathway. Further investigation is warranted to elucidate the Piezo1-dependent mechanisms involved in lupus-associated cardiovascular disease. Veterans Affairs Biomedical Laboratory Research & Development Career Development Award (CDA-2) 1IK2BX005605-01 to J.P.V.B, Medical University of South Carolina College of Medicine Program Project Grant to and J.P.V.B., and Medical University of South Carolina Core Centers for Clinical Research Project Award P30AR072582 to M.A.C and J.P.V.B. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Cardiac Sodium Channel Nav1.5 Arg222Gln Variant Induces a Sex-Specific Arrhythmia and Alters Mitochondrial Function

Introduction: Encoded by the SCN5A gene, cardiac Nav1.5 sodium channels initiate the action potential to trigger a heartbeat. As the predominant sodium channel in the heart, variants can have devastating consequences, leading to potentially lethal arrhythmias. With the gain of function arginine to glutamine (Arg222Gln) variant in Nav1.5, patients develop intermittent arrhythmias and dilated cardiomyopathy. The stress induced by chronic arrhythmias can trigger adverse metabolic reprogramming, exacerbating the underlying condition. We have generated a murine model harboring the human Arg222Gln variant where we observe that only males produce a clear observable arrhythmia. We hypothesize that the maladaptive metabolic response to the arrhythmia caused by the Arg222Gln variant maybe be a potential link to the sex differences. Methods: The human exon containing the Arg222Gln mutation was knocked into a murine model under the endogenous SCN5A promoter. Cellular metabolism (oxygen consumption) was measured using primary adult mouse cardiomyocytes (CMs) with the Seahorse XFe analyzer. Mitochondrial membrane potential was measured using ratiometric JC-1 dye and imaged on a scanning confocal microscope. Heart tissues were diced into 1mm3 cubes and fixed to perform serial block face electron microscopy to obtain 3D structure of mitochondria and mitochondrial morphology. Western blots were used to detect protein levels. Results: Basal respiration of CMs were unchanged, however the maximal respiratory capacity of Arg222Gln males was significantly lower (116.9±13.5pmol O2/min, p<0.05) compared to WT males (407.3±16.4pmol O2/min). There were no differences between WT females (451.4±22.4pmol O2/min) and Arg222Gln females (463.2±33.7pmol O2/min). JC-1 dye revealed that the Arg222Gln males (0.6213±0.0172 red/green ratio, p<0.001) have significantly lowered mitochondrial polarization compared to WT males (0.7550 ±0.0257). There were no differences between WT females (0.6236±0.0154) and Arg222Gln females (0.6466±0.0139). Arg222Gln males have reduced mitochondria area (1.155±0.052μm2, p<0.05) compared to WT males (1.332±0.060μm2) and are more fragmented (p<0.05). Electron transport chain complex protein levels and mitochondrial biomass measured by voltage dependent anion channel protein levels remain unchanged between WT males and Arg222Gln males (P>0.05). The ratio of phosphorylated dynamin related (DRP) / total DRP protein levels were significantly higher in Arg222Gln males compared to WT males, indicative of mitochondrial fission (p<0.05). Conclusion: We demonstrate evidence of a mitochondrial dysfunction in a murine model of arrhythmia caused by a gain of function Nav1.5 variant, adversely affecting overall cellular metabolism and mitochondrial quality. Our data suggests that the difference in metabolic reprogramming could play a role in the cardioprotection against arrhythmia in Arg222Gln females or explain why Arg222Gln males are severely affected by the arrhythmia. Future experiments will aim to elucidate how the difference in sex affects cardiac metabolism in the context of Arg222Gln Nav1.5 variant. This work was supported by a Canadian Institutes of Health Research Project Grant, the SickKids Foundation through the Curtis Joseph and Harold Groves Chair in Anesthesia and Pain Medicine (JTM) and the Department of Anesthesiology and Pain Medicine, University of Toronto through a Merit Award (JTM). TYTL is supported by the CIHR Canadian Graduate Scholarship — Doctoral Award. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Mathematical Modeling of Magnesium Homeostasis in Male Rats

Magnesium (Mg2+) is an important cofactor for numerous biological processes, including protein synthesis, nucleic acid stability, and neuromuscular excitability. Extracellular magnesium is tightly regulated, with plasma [Mg2+] maintained relatively constant between 1.6 and 2.3 mg/dL under normal physiological conditions. Almost all of the body’s Mg2+ (approximately 99%) is either stored in bone or within cells (DOI: 10.1053/j.ackd.2018.01.003). A normal daily Mg2+ intake averages around 300 mg, about half of which is absorbed by the intestine. The kidneys reabsorb 95-98% of the filtered Mg2+ and excrete only 2-5% through urine. To understand the interplay between intestine, kidneys, and bones to maintain Mg2+ homeostasis, we developed a computational model of Mg2+ homeostasis for male rats and incorporated it with a male rat calcium (Ca2+) homeostasis model. Our model consists of five compartments: plasma, intestine, kidneys, bones, and parathyroid gland. The model also includes parathyroid hormone and vitamin D3 since they significantly regulate Mg2+ and Ca2+ homeostasis. We used this model to simulate three conditions: change in dietary Mg2+, change in dietary vitamin D3, and administration of proton-pump inhibitors. In the case of variation in dietary Mg2+, our model predicted that the body compensates mainly through decreasing (in case of low dietary Mg2+) and increasing (in case of high dietary Mg2+) urinary Mg2+ excretion and the Mg2+ content in the rapidly exchangeable bone pool. Change in dietary Mg2+ does not have any significant effect on Ca2+ homeostasis. On the other hand, change in dietary vitamin D3 has significant effect on both Mg2+ and Ca2+ homeostasis, with the effect being more pronounced for Ca2+ compared to Mg2+. Our model predicted significant changes in intestinal Mg2+ and Ca2+ absorption, PTH secretion, urinary Mg2+ and Ca2+ excretion, and Mg2+ and Ca2+ content in the rapidly exchangeable bone pool following change in dietary vitamin D3. Administration of proton pump inhibitors (PPIs) such as omeprazole, which are a class of medicine commonly used to reduce stomach acid production, affect Mg2+ and Ca2+ transport in the intestine. PPIs reduce intestinal Mg2+ and Ca2+ absorption by 3.5-fold and 40%, respectively. The body compensates for this huge drop in intestinal Mg2+ absorption by tapping into the Mg2+ stored in the rapidly exchangeable bone pool in addition to decreasing urinary Mg2+ excretion. By contrast, the body can compensate for the drop in intestinal Ca2+ absorption by only decreasing urinary Ca2+ excretion. Thus, this model can be used to understand the compensatory mechanisms adopted by the body to maintain Mg2+ and Ca2+ homeostasis under various pathophysiological conditions and drug administrations. This work was supported by the Canada 150 Research Chair program, National Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant, and Canada Institutes of Health Research (CIHR) Project Grant to Anita Layton. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

The mammalian sperm factor phospholipase C zeta is critical for early embryo division and pregnancy in humans and mice.

The mammalian sperm factor phospholipase C zeta is critical for early embryo division and pregnancy in humans and mice.

P186 Impact of glucocorticoids on appearance and sense of self in rheumatic diseases

Abstract Background/Aims To explore patients’ perspectives on the impact of appearance changes attributed to glucocorticoid treatment. Methods We conducted a secondary analysis of semi-structured interviews with patients with rheumatic conditions receiving glucocorticoids in the UK, USA, and Australia. Interview data were analysed inductively to develop preliminary individual and overarching themes. Results 60 patient interviews were analysed. Patients ranged from 26-84 years, and 39 (65%) were female. Patients had diagnoses of systemic vasculitis (n = 19), inflammatory arthritis (n = 14), crystal arthropathy (n = 2), connective tissue disorders (n = 16), or other/multiple (n = 9). Interviews contained rich data on how appearance changes impacted health-related quality of life. Three preliminary overarching themes were identified. i) Societal influences: participants reported pressure to conform to cultural and societal ideals: “I think with the weight gain it was more of an emotional response. [⋯] There's a part of you that's thin is better. So, I think that impacted me the most, just because of that aspect of what others thought of me…” (Female [Mixed/Multiple ethnicity] aged 27, granulomatosis with polyangiitis [Australia]) and “…within a week my dad had seen me and said, “Gosh you’ve put on a lot of weight”. Obviously, that’s not what I want to hear [⋯] but I think it was just pure shock." (White female aged 40, eosinophilic granulomatosis with polyangiitis [UK])”.ii)?Impact on mental health and sense of self: glucocorticoids were often described as making participants ‘not look like’ themselves, associated with changes in mood, self-confidence, and reluctance to socialise: “It makes you feel down. It makes you feel depressed. You don't want to socialise because you're not you.” (White male aged 65, inflammatory myositis [Australia]) and “Yeah, that’s it and it will hopefully look nice, which is a really vain thing to think about isn’t it, but it does really affect [⋯] how you feel and kind of your state of mind and things…” (White female aged 39, Takayasu arteritis [UK]). iii) Burden of adjustments included dieting, purchasing additional clothing sizes, working from home, discontinuing hobbies, and postponing key life events: "I have a wardrobe right now that goes four different sizes as my weight goes up and down and up and down." (White female aged 55, systemic lupus erythematosus [USA]) and "Well, with the high dose of prednisone since I gained weight, I get really tired if I try to do like exercise or something. And I used to be very sporty, so that just completely changed." (Hispanic female aged 29, systemic lupus erythematosus [USA]). Conclusion Patients attribute a variety of impacts on their health-related quality of life to glucocorticoid-related appearance changes and report a burden of adjustments above management of their chronic rheumatic condition. Further work is required to establish ways to mitigate these through improved information provision and support. Disclosure S.J. Lax: Grants/research support; post funded by National Institute for Health and Care Research Advanced Fellowship [grant number NIHR300863]. E. Dures: Grants/research support; recipient of grants from Above & Beyond Bristol Hospitals Charity, UWE Bristol, Vifor Pharma, National Institute for Health and Care Research (Research for Patient Benefit) and Sanofi. S. Bridgewater: None. C. Silverthorne: None. V. Lowndes: None. P. Richards: None. J. Dawson: None. C. Hill: Grants/research support; recipient of an Australian Rheumatology Association Project Grant, administered by Arthritis Australia. S. Goodman: None. S.L. Mackie: None. M.E. Ndosi: None. F.A. Pearce: Grants/research support; recipient of a National Institute for Health and Care Research Advanced Fellowship [grant number NIHR300863] and a grant from Vifor pharma. J. Robson: Consultancies; consultancy and speaking fees from Vifor Pharma. Grants/research support; recipient of grants from Above & Beyond Bristol Hospitals Charity, UWE Bristol, Vifor Pharma, National Institute for Health and Care Research (Research for Patient Benefit) and Sanofi.

0445 Comparing Adherence for a Prescription Digital Therapeutic for Insomnia Across Controlled and Real-world Settings

Abstract Introduction Digital Cognitive Behavioral Therapy for insomnia (dCBT-I) offers scalable first-line treatment versus face-to-face care, but a potential trade-off is lower treatment adherence. In clinical trials, adherence rates to dCBT-I have been variable, and there is no defined standard for acceptable adherence to dCBT-I. Further, the generalizability of adherence data from clinical trials to real-world settings is unknown. This study compared adherence data from two dCBT-I clinical trials to adherence within a real-world study. Methods The dCBT-I intervention was a prescription digital therapeutic (Somryst) that includes 6 treatment Cores (e.g., sleep restriction, stimulus control) delivered over 9 weeks. Participants must complete a Core and wait 7 days before starting the next Core. Clinical trial adherence data was derived from two RCTs previously submitted to FDA as part of its authorization (RCT-1 [USA; N=151, age 21-65 years] and RCT-2 [Australia; N=574, age 18-64 years]). Real-world adherence data was derived from a prospective, single-arm, pragmatic clinical study (DREAM [USA; N=991, age ≥18 years]). Adherence was defined as the percentage of participants with dCBT-I access who completed each treatment Core. Automated notifications prompt engagement with the therapeutic. Results Real-world adherence rates from the DREAM study were 94.1%, 71.1%, 60.7%, 55.7%, 49.1%, and 42.8% for Cores 1-6. For RCT-1, adherence rates of Cores 1-6 were 93.4%, 88.1%, 76.8%, 67.5%, 66.9%, and 60.3%, respectively, whereas adherence rates of Cores 1-6 in RCT-2 were 80.8%, 67.9%, 60.5%, 54.0%, 47.6%, and 40.8%. Conclusion Real-world adherence to dCBT-I appears comparable to RCTs, with the largest decrease occurring between Cores 1 and 2. These findings support the generalizability of adherence data from RCTs and potential opportunities to increase adherence early in treatment. Further work is needed to determine acceptable standards for adherence to dCBT-I in the real world. Support (if any) DREAM study: Pear Therapeutics, Inc. RCT-1: NIMH grant #R01 MH86758; NCT01438697. RCT-2: NHMRC project grant #1005867; ACTRN12611000121965. Additional support provided by Nox Health, Inc.

Eco-efficient asphalt recycling for urban slow mobility

Cycling infrastructures contribute to advancing zero-impact transport systems, aligning with the European Commission’s proactive climate change mitigation policies. This paper explores the potential of innovative and sustainable pavements for cycling paths with mixtures composed of road-milling materials. This investigation involves low-environmental-impact bituminous-based mixtures differing from recipe, mixing method, and laying. Up to 100% secondary aggregates are used as alternative materials to design the Grande Raccordo Anulare delle Biciclette (GRAB), a 44-km cycling ring in Rome. According to the European standard EN 15804, their “from cradle to gate” life cycle analysis allows a comprehensive assessment and comparison of the environmental impact. Core and additional environmental impact categories and resource use indicators were quantified using primary data from asphalt producers and secondary data from the Ecoinvent database in the SimaPro software. Within the H2020 InfraROB project (grant agreement no. 955337), which aims at enhancing road infrastructure integrity, performance, and safety through autonomous robotic solutions and modularization, experimental sections have been constructed using a cold-mixed asphalt composed entirely of recycled asphalt and a rejuvenating additive. The results underscore the potential of the examined low-impact approach in conserving Earth’s resources, ensuring long-lasting infrastructure for vulnerable urban populations and fostering sustainable environmental management.

Grants for global pathology quality services projects

Grants for global pathology quality services projects

Gut bacteriome and mood disorders in women with PCOS.

How does the gut bacteriome differ based on mood disorders (MDs) in women with polycystic ovary syndrome (PCOS), and how can the gut bacteriome contribute to the associations between these two conditions? Women with PCOS who also have MDs exhibited a distinct gut bacteriome with reduced alpha diversity and a significantly lower abundance of Butyricicoccus compared to women with PCOS but without MDs. Women with PCOS have a 4- to 5-fold higher risk of having MDs compared to women without PCOS. The gut bacteriome has been suggested to influence the pathophysiology of both PCOS and MDs. This population-based cohort study was derived from the Northern Finland Birth Cohort 1966 (NFBC1966), which includes all women born in Northern Finland in 1966. Women with PCOS who donated a stool sample at age 46years (n = 102) and two BMI-matched controls for each case (n = 205), who also responded properly to the MD criteria scales, were included. A total of 102 women with PCOS and 205 age- and BMI-matched women without PCOS were included. Based on the validated MD criteria, the subjects were categorized into MD or no-MD groups, resulting in the following subgroups: PCOS no-MD (n = 84), PCOS MD (n = 18), control no-MD (n = 180), and control MD (n = 25). Clinical characteristics were assessed at age 31years and age 46years, and stool samples were collected from the women at age 46years, followed by the gut bacteriome analysis using 16 s rRNA sequencing. Alpha diversity was assessed using observed features and Shannon's index, with a focus on genera, and beta diversity was characterized using principal components analysis (PCA) with Bray-Curtis Dissimilarity at the genus level. Associations between the gut bacteriome and PCOS-related clinical features were explored by Spearman's correlation coefficient. A P-value for multiple testing was adjusted with the Benjamini-Hochberg false discovery rate (FDR) method. We observed changes in the gut bacteriome associated with MDs, irrespective of whether the women also had PCOS. Similarly, PCOS MD cases showed a lower alpha diversity (Observed feature, PCOS no-MD, median 272; PCOS MD, median 208, FDR = 0.01; Shannon, PCOS no-MD, median 5.95; PCOS MD, median 5.57, FDR = 0.01) but also a lower abundance of Butyricicoccus (log-fold changeAnalysis of Compositions of Microbiomes with Bias Correction (ANCOM-BC)=-0.90, FDRANCOM-BC=0.04) compared to PCOS no-MD cases. In contrast, in the controls, the gut bacteriome did not differ based on MDs. Furthermore, in the PCOS group, Sutterella showed positive correlations with PCOS-related clinical parameters linked to obesity (BMI, r2=0.31, FDR = 0.01; waist circumference, r2=0.29, FDR = 0.02), glucose metabolism (fasting glucose, r2=0.46, FDR < 0.001; fasting insulin, r2=0.24, FDR = 0.05), and gut barrier integrity (zonulin, r2=0.25, FDR = 0.03). Although this was the first study to assess the link between the gut bacteriome and MDs in PCOS and included the largest PCOS dataset for the gut microbiome analysis, the number of subjects stratified by the presence of MDs was limited when contrasted with previous studies that focused on MDs in a non-selected population. The main finding is that gut bacteriome is associated with MDs irrespective of the PCOS status, but PCOS may also modulate further the connection between the gut bacteriome and MDs. This research was funded by the European Union's Horizon 2020 Research and Innovation Programme under the Marie Sklodowska-Curie Grant Agreement (MATER, No. 813707), the Academy of Finland (project grants 315921, 321763, 336449), the Sigrid Jusélius Foundation, Novo Nordisk Foundation (NNF21OC0070372), grant numbers PID2021-12728OB-100 (Endo-Map) and CNS2022-135999 (ROSY) funded by MCIN/AEI/10.13039/501100011033 and ERFD A Way of Making Europe. The study was also supported by EU QLG1-CT-2000-01643 (EUROBLCS) (E51560), NorFA (731, 20056, 30167), USA/NIH 2000 G DF682 (50945), the Estonian Research Council (PRG1076, PRG1414), EMBO Installation (3573), and Horizon 2020 Innovation Grant (ERIN, No. EU952516). The funders did not participate in any process of the study. We have no conflicts of interest to declare. N/A.

Students' assessment of the results of social project activities as a factor of its quality and effectiveness

The relevance of the problem under study is confirmed by its practice-oriented nature, the need to use social technologies that are in demand in modern conditions in pedagogical practice and in the management of project activities. The research problem is assessing the quality of the results of social project activities as one of the stages of managing this type of activity in educational institutions. The purpose of the study is to develop and test methodological support for assessing the results of social project activities of students at the university. The research was based on experimental and sociological methods, as well as on the axiological approach of philosophy and pedagogy. It was carried out based on the results of a implemented grant from the Federal Agency for Youth Affairs. Contains a developed and tested technology for assessing a large-scale social grant project, which is quite universal and can be used and adapted to similar projects.

270 Four Pillars of Community Health and Research Engagement: The UT Southwestern CTSA Program’s Innovative Approach to Putting the Community Health Science Model into Practice

OBJECTIVES/GOALS: Goals: Engage in collaborative approaches that target health disparities, especially among communities experiencing poverty or ethnic/racial minorities. Develop and sustain effective community-academic partnerships that foster trust through bidirectional communication and shared leadership leading to improved translational research. METHODS/STUDY POPULATION: The Community Health Science model was developed at UTSW over the past 20 years in efforts to integrate practices across 3 component areas – clinical practice, population health, and community organizations – into a single collaborative effort to improve health and reduce disparities. As part of the CTSA Program’s translational science efforts, we have extended this model to promote community engagement in research as an additional strategy needed to achieve health equity. Our Office of Community Health &amp; Research Engagement operates 9 programs that each fit within one or more of 4 overarching conceptual pillars - Education/Resources, Collaboration/Partnership, Outreach/Service, Priorities/Perspectives - serving to bridge the community-academic divide and build strong, trusting relationships. RESULTS/ANTICIPATED RESULTS: The implementation of our model has resulted in measurable outcomes. To date, we have hosted 23 HealthStreet community events resulting in 464 health screenings, 203 health needs assessments completed, and 123 individuals joining our Community Research Registry allowing for future contact to participate in research. Our Community Health Coalition, comprised of 32 organizations, provides a forum for co-learning between researchers and stakeholders. We have awarded 9 grants ($175,800) for community-engaged projects. Our Community Advisory Panel has participated in 8 sessions with research teams. A total of 13 projects utilized the Spanish Language Resource, for a total of 30,617 translated words. Finally, we have hosted 9 Community Engagement Grand Rounds lectures, which included a total of 559 attendees. DISCUSSION/SIGNIFICANCE: Our model strengthens our capacity to build trust with communities and facilitate sustained community-academic partnerships. By prioritizing community engagement in research, we improve health equity by understanding community perspectives and increasing diversity in trials. We hope our model can be disseminated and scaled for greater impact.